Robert L. Koegel

Positive Behavior Support Evolution of an Applied Science

Positive behavior support (PBS) is an applied science that uses educational and systems change methods (environmental redesign) to enhance quality of life and minimize problem behavior. PBS initially evolved within the field of developmental disabilities and emerged from three major sources: applied behavior analysis, the normalization/inclusion movement, and person-centered values. Although elements of PBS can be found in other approaches, its uniqueness lies in the fact that it integrates the following critical features into a cohesive whole: comprehensive lifestyle change, a lifespan perspective, ecological validity, stakeholder participation, social validity, systems change and multicomponent intervention, emphasis on prevention, flexibility in scientific practices, and multiple theoretical perspectives. These characteristics are likely to produce future evolution of PBS with respect to assessment practices, intervention strategies, training, and extension to new populations. The approach reflects a more general trend in the social sciences and education away from pathology-based models to a new positive model that stresses personal competence and environmental integrity.

A natural language teaching paradigm for nonverbal autistic children

The purpose of this study was to attempt to improve verbal language acquisition for nonverbal autistic children by manipulating traditional teaching techniques so they incorporated parameters of natural language interactions and motivational techniques. Within a multiple baseline design, treatment was conducted in a baseline condition with trials presented serially in a traditional analogue clinical format where the therapist presented instructions, prompts, and reinforcers for correct responses. Then, these variables were manipulated in the natural language teaching condition such that (a) stimulus items were functional and varied, (b) natural reinforcers were employed, (c) communicative attempts were also reinforced, and (d) trials were conducted within a natural interchange. Treatment and generalization data demonstrated that manipulation of these variables resulted in broadly generalized treatment gains. Implications for language intervention are discussed.

Pivotal Response Intervention I: Overview of Approach.

The purpose of this article is to present an overview of several pivotal response interventions. Our research at the University of California, Santa Barbara, has been focused on attempting to identify pivotal areas that, when changed, result in concomitant positive changes in other areas. Pivotal areas that are discussed include responsivity to multiple cues, motivation to initiate and respond appropriately to social and environmental stimuli, and self-regulation of behavior, including self-management and self-initiations. The trend to streamline intervention by targeting behaviors that will have widespread effects on development, rather than targeting individual behaviors one at a time, is discussed.

Consistent Stress Profiles in Mothers of Children with Autism.

The present study extends the area of research on stress in parents of autistic children. In this study we used the Questionnaire on Resources and Stress (Holroyd, 1987) to compare the stress profiles across mothers (a) who lived in different cultural and geographic environments; (b) who had children of different ages; and (c) who had children with different functioning levels. Results showed a characteristic profile that was highly consistent across each of these subgroups. Major differences from the normative data occurred on scales measuring stress associated with dependency and management, cognitive impairment, limits on family opportunity, and life-span care. Results suggest the importance of developing treatment programs aimed at reducing stress in specific areas in families with autistic children.

Toward a Technology of "Nonaversive" Behavioral Support.

Nonaversive behavior management is an approach to supporting people with undesirable behaviors that integrates technology and values. Although this approach has attracted numerous proponents, more adequate definition and empirical documentation are still needed. This article presents an introduction to the nonaversive approach. Important definitions are suggested, and three fundamental elements are presented: (a) an emerging set of procedures for supporting people with severe challenging behavior; (b) social validation criteria emphasizing personal dignity; and (c) a recommendation for prohibition or restriction of certain strategies. These elements are defined in hopes of stimulating further discussion and empirical analyses of positive behavioral support.

Collateral effects of parent training on family interactions

Recent research suggests that using naturalistic teaching paradigms leads to therapeutic gains in clinic settings for children with autism and related disorders. More recent studies are demonstrating that implementing these strategies within a parent training format may produce collateral effects in other areas of family life. The present experiment assessed collateral effects of two very different parent training paradigms during unstructured dinnertime interactions in the family setting. One paradigm focused on teaching individual target behaviors (ITB) serially, and the other focused on a recently developed naturalistic paradigm that teaches the pivotal responses (PRT) of motivation and responsivity to multiple cues. Two groups of families were randomly assigned to each of the parent training conditions. Pretraining and post- parent- training videotapes of dinnertime interactions were scored in a random order across four interactional scales (level of happiness, interest, stress, and style of communication). Results obtained for the four interactional scales showed that the families in both conditions initially scored in the neutral range, and the ITB training paradigm produced no significant influence on the interactions from pretraining to posttraining. In contrast, however the PRT parent training paradigm resulted in the families showing positive interactions on all four scales, with the parent-child interactions rated as happier, the parents more interested in the interaction, the interaction less stressful, and the communication style as more positive.

Pivotal Response Intervention II: Preliminary Long-Term Outcome Data

The literature and our observations suggest that self-initiations may be an especially important part of intervention for children with autism. Therefore, the purpose of this study was to conduct preliminary assessments as to whether self-initiations might be associated with highly favorable postintervention outcomes. In the first phase of this study, archival data were analyzed for 6 children. At intake, according to traditional variables, they appeared to have especially good prognoses for reducing symptoms of autism, but had extremely different outcomes (either exceptionally good or exceptionally poor) after years of intensive intervention. Results of Phase 1 indicated that the children who had highly favorable outcomes exhibited more spontaneous self-initiations at preintervention. Given these results, Phase 2 of the study assessed whether a series of self-initiations could be taught to children with autism who demonstrated few or no spontaneous self-initiations at preintervention, and whether this intervention would result in highly favorable postintervention outcomes. Results indicated that these children learned a variety of self-initiations and had extremely favorable outcomes. The results of this exploratory study are encouraging in terms of assessment of key pivotal target behaviors that may be identified as prognostic indicators, and that may be important during intervention for children with autism.

Pivotal Areas in Intervention for Autism

Discusses several core pivotal areas that appear to be influential in intervention for autism. Literature and outcome data are reviewed with respect to several core areas that appear to be particularly helpful in intervention for autism, including improving motivation, responsivity to multiple cues, self-management, and self-initiation of social interactions. A conceptual framework is described, and outcome data are reviewed suggesting that when children with autism are motivated to initiate complex social interactions, it may reverse a cycle of impairment, resulting in exceptionally favorable intervention outcomes for many children. Because the peripheral features of autism can be numerous and extensive, the concept of intervention for pivotal areas of functioning may be critical if children are to be habilitated in a time- and cost-efficient manner.

Using Parent/Clinician Partnerships in Parent Education Programs for Children with Autism.

Recently, many treatments for children with disabilities have shifted from a purely clinician-implemented model to one that focuses on a parent education component. In the current study, a repeated reversal design was employed to compare the effects of a parent education intervention that incorporates the principles outlined in the parent empowerment and ecocultural literature with a professional-driven model that does not incorporate these principles. The Parent/Clinician Partnership and Clinician-Directed models were compared on the following measures: (a) observed parent stress, (b) observed parent confidence, (c) observed child affect, and (d) child responsiveness and engagement. The results are discussed in terms of the implications for parent education programs and the relationships between clinical outcome and the type of parent education procedures implemented.

Language Intervention and Disruptive Behavior in Preschool Children with Autism.

Disruptive behaviors are often exhibited by children with severe disabilities during difficult teaching tasks. Because learning verbal communication can be a difficult task for nonverbal children with autism, disruptive behaviors are common during such interventions. The purpose of this experiment was to assess whether the incorporation of parameters of natural language interactions and motivational techniques might reduce disruptive behavior during language teaching tasks. Within a repeated reversals design with order of conditions and number of sessions varied within and across children, treatment was conducted for two language teaching conditions. During one condition trials were presented serially in a traditional analog clinical format where the therapist presented instructions, prompts, and reinforcers for correct responses. The other condition incorporated parameters of natural language interactions and motivational techniques, such that stimulus items were functional and varied; natural reinforcers were employed; communicative attempts were reinforced; and trials were conducted within a natural interchange. Results showed that greater improvements in responding and considerably less (often negligible) disruptive behavior occurred during the natural language teaching conditions. Results are discussed with respect to their implications for improving language interventions, and with respect to reducing disruptive behavior without the need for specialized or severe interventions focused specifically on the disruptive behavior.